219750 05/07/2013 CITY OF CARMEL, INDIANA VENDOR: 118000 Page 1 of 1
0 ONE CIVIC SQUARE HACH COMPANY CHECK AMOUNT: $3,972.62
CARMEL, INDIANA 46032 2207 COLLECTIONS CENTER DRIVE
CHICAGO IL 60693 CHECK NUMBER: 219750
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CHECK DATE: 5/7/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 8248417 3 , 972 . 62 OTHER EXPENSES
....... .... �. ._.
INVOICE NO 8248417 DATE: 1 04/12/2013
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0 CARMEL UTILITIES ORDER
L NUMBER
D 3450 W 131st St Net 30 Days From Invoice Date
Carmel, IN 46074-8267 TERMS
T United States
0 FREIGHT Prepay And Bill Customer
CARRIER RPS-RPS**FedEx--Ground
S
H CARMEL UTILITIES 1ACCOUNT 1052653
1 FOREMAN,JAIMIE I REE. NQ, 1312608606-1 Remit to:
P 4915 E 106TH ST Hach Company
CARMEL, IN 46033 2207 Collections Center Dr
T United States Chicago,IL 60693
O Phone:(800)227-4224
These commodities are sold,packaged,marked,and labeled for destinations in the United States. Exportation of these commodities may require special licensing,packaging,marking or labeling
LN# PRODUCT DESCRIPTION ITEM NO. QUANTITY UNIT PRIC EXT. PRICE
2 FERROUS IRON RGT PP 25ML PK/100 103769 10 24.05 240.50
*TRACKING NUMBERS:050316371371133
3 RGT 1, TISAB SOLN 473ML 2812811 12 30.75 369.00
*TRACKING NUMBERS:050316371371133
4 KIT, CL17 PRE-ASSY MAINT, POST 3/00 5444301 6 196.00 1,176.00
*TRACKING NUMBERS:050316371371133
5 SULFURIC ACID 1.600N, CARTRIDGE 1438901 2 17.85 35.70
*TRACKING NUMBERS:050316371371133
6 ASCORBIC ACID PWD PLWS PK/100 1457799 10 20.85 208.50
*TRACKING NUMBERS:050316371371133
7 FERROVER, IRON REAGENT PK/100 2105769 10 21.39 213.90
*TRACKING NUMBERS:050316371371133
8 EDTA STD SOLN, 0.035N 100ML MDB 2349932 1 15.15 15.15
*TRACKING NUMBERS:050316371371133
9 as REAGENT SET, CHLORINE FREE CL17 2556900 8 49.59 396.72
*TRACKING NUMBERS:050316371371126
10 as REAGENT SET, CHLORINE TOTAL CL17 2557000 21 52.09 1,093.89
*TRACKING NUMBERS:050316371371119
050316371371126
PURCHASE AND ACCEPTANCE OF PRODUCT(S)SUBJECT TO HACH COMPANY'S TERMS AND CONDITIONS OF SALE,
PUBLISHED ON HACH COMPANY'S WEBSITE AT WWW.HACH.COMITERMS
For order discrepancies or product exchanges please call 800-227-4224 or 970-669-3050 to obtain Return Authorization.
FEDERAL TAX ID#42-0704420
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Test Systems Other brands°
17< from Hach
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Flow Products d y:rvia:s
® INVOICE NUMBER 8248417
DATE: 04/12/2013
Page: 2
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LN# PRODUCT DESCRIPTION ITEM NO. QUANTITY UNIT PRIC EXT. PRICE
11 FLUORIDE STD, 0.5MG/L 473ML 2743811 3 21.25 63.75
*TRACKING NUMBERS:050316371371133
12 FLUORIDE STD, 5.OMG/L 473ML 2797111 4 22.39 89.56
*TRACKING NUMBERS:050316371371133
ORDER CONTACT: SUBTOTAL 3,902.67
JAIMIE FOREMAN FREIGHT CHARGES 69.95
(317) 571-2639 TAX 0.00
Notes: INVOICE TOTAL 3,972.62
I
PURCHASE AND ACCEPTANCE OF PRODUCT(S)SUBJECT TO HACH COMPANY'S TERMS AND CONDITIONS OF SALE,
PUBLISHED ON HACH COMPANY'S WEBSITE AT WWW.HACH.COM/TERMS
For order discrepancies or product exchanges please call 800-227-4224 or 970--669--3050-to-obtain-Return Authorization.
FEDERAL TAX ID#42-0704420
°aEnvironmental o e Other brands
Test Systems from R,
® •" ^ ••, �ot Flow ProftefS a SeIVIMS As.,khr or.n. 9� m 67��rB9
Prescribed by State Board of Accounts City Form No.201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
118000
HACH CHEMICAL CO. CORP Purchase Order No.
2207 Collections Center Dr. Terms
Chicago, IL 60693 Due Date 4/30/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/30/2013 8248417 $3,972.62
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
correct and I have audited same in accordance with IC 5-11-10-1.6
Date Officer
VOUCHER # 131492 WARRANT # ALLOWED
118000 IN SUM OF $
HACH CHEMICAL CO. CORP
2207 Collections Center Dr.
Chicago, IL 60693
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
8248417 01-6200-03 $3,902.67
8248417 01-6200-03 $69.95
Voucher Total $3,972.62
Cost distribution ledger classification if
claim paid under vehicle highway fund